environmental health

Spring is in the air (although it’s snowing as I’m writing this blog), which means prime allergy season has begun! The common cold is also still prevalent in the ever-changing weather of Ohio. Here are some facts about the differences between two similar presenting diseases and some tips on how to treat them! ALLERGIESStudents may be more likely to develop allergies while attending college. This could be due to living in a different region that has different pollens in the air and students may be exposed to different allergens. Allergy symptoms occur quickly after exposure to an allergen and will last as long as you are exposed to the allergen. Common symptoms include: runny or stuffy nose, sneezing, wheezing, and watery or itchy/dry eyes.

Colds are caused by a virus, and very rarely are caused by bacteria. They mimic the same symptoms as allergies, but may also include fever, sore throat, and body aches. Colds develop over several days and usually your body can clear the virus within several days to a week. Warning signs that you may have a bacterial infection (NOT the common cold) are vomiting or diarrhea along with fever and body aches and other common cold/allergy symptoms. If you have these symptoms it’s important to see a doctor and stay hydrated!

Both allergies and the common cold have the same over-the-counter (OTC) treatment choices and non-medication related recommendations to help alleviate symptoms.

Growing up sleeves were a big no-no. We weren’t supposed to use our sleeves to wipe our noses or our mouths. We weren’t supposed to stretch out our sleeves. And we weren’t to use our sleeves as rags to wipe things down. Sleeves were to be – well – sleeves.

The wiping of the nose thing – that’s still good advice, but our sleeves can serve a purpose other than being sleeves. Sleeves are great for coughing and sneezing. If you’re coughing/sneezing into your sleeve, you’re limiting the spread of germs into the air, protecting those around you.

In this well-known scene from Caddy Shack, panic ensues when “doodie” is found in the pool. While the movie is all in good fun, there’s actually some truth in there as well. Crypto, AKA Cryptosporidium, is a microscopic parasite that can affect both humans and animals. It lives in the intestines and is passed in the stool of an infected person or animal. The most common means of transfer – water. It is actually one of the most common causes of waterborne disease, both through recreational water such as swimming pools or lakes, and drinking water. This parasite is very resilient and has a hard outer shell which allows it to survive outside the body for long periods of time and also makes it resistant to chlorine.

Those most at risk for contracting crypto are:

Children who attend day care centers

Child care workers

International travelers

Backpackers, hikers, and campers who drink unfiltered, untreated water

People, including swimmers, who swallow water from contaminated sources

People who handle infected cattle

People exposed to human feces through sexual contact

The most common symptom of crypto is watery diarrhea. Other symptoms include:

Stomach cramps or pain

Dehydration

Nausea

Vomiting

Fever

Weight loss

If you become infected with crypto, you can expect the symptoms to appear in 2-10 days. They will usually last about 1-2 weeks and may go in cycles where you seem to get better and then feel worse before the illness ends. Most people with a healthy immune system recover without treatment. An over the counter anti-diarrheal medicine can help and it’s important to drink plenty of fluids to prevent dehydration.

Crypto is very contagious. The following steps should be taken by those infected with Crypto to avoid spreading the disease to others:

Wash your hands frequently and thoroughly with soap and water, especially after changing diapers, using the toilet, and before eating or preparing food.

For at least 2 weeks after the diarrhea has stopped, do not swim in recreational water. You can contaminate water for several weeks after the symptoms have ended.

Avoid sexual practices, such as oral-anal contact, that bring you in contact with fecal matter.

Avoid contact with people who have a weakened immune system.

Do not put children who have Crypto in a child care setting until the diarrhea has ended.

If you suspect you have crypto, or your symptoms are not improving, schedule an appointment at Student Health Services or with your health care provider.

In the meantime – if you see “doodie” in the pool, play out that scene in Caddy Shack and get out of the water ASAP!!

A: Eczema, the “itch that scratches”, is a chronic inflammatory skin problem that causes a characteristic red, itchy rash. It commonly occurs on skin overlying joints and other areas that stretch and fold, but can occur anywhere on the body.

The cause of eczema remains a mystery. We know a couple of things, though. It often occurs in families. When one identical twin is affected there is an 80% chance the other will have eczema too. Overall, about 20% of the population in the US has eczema. It typically starts before five years of age, affects city folk more than rural inhabitants, and females a little more than males.

Eczema can be mild and limited or there can be diffuse involvement over a lot of the skin surface. Often eczema is worse in the winter, when skin tends to be drier by virtue of the harsh environment. While we don’t know what causes eczema, we know that the top layer of the skin-the thin epidermal line that protects you from the environment-becomes disrupted. The tissue can’t retain moisture effectively and leaves you susceptible to infection.

The mainstays of therapy to protect the barrier involve both medication and lifestyle modification. Steroid creams are first line treatments. They work like a charm but can be tricky to use in the long run: they make skin thinner (which restricts their use on the face and neck where skin is already thin); they can cause a rash that looks like acne; can leave skin discolored and can also cause stretch marks. When we have to use a steroid, we try to use one with the lowest potency for the shortest amount of time necessary to keep the eczema under control.

The other equally important part of treatment has two parts: avoiding triggers and adding moisture to the skin.

Anything that might make already inflamed skin more irritated should be avoided. For example, perfumes, lotions with alcohol base and fragrance, certain detergents, deodorant soaps, or wool clothes can be quite irritating to somebody with eczema.

Long hot showers dry the skin (especially in the winter) and they release histamine from the mast cells in the dermis, making you itch and scratch like a fiend, which further disrupts the barrier.

A good, thick emollient is key. Petroleum jelly is the gold standard, but it’s hard to use. It stains clothes and bedding and covering your whole body in it is, well, icky and sticky. The thicker the emollient, though, and the sooner you use it after bathing the better. Ointments are generally better than lotions at moisturizing. Eucerin, Cetaphil, and Nutraderm are good products.

Antihistamines like loratadine (Claritin) or diphenhydramine (Benadryl) are sometimes helpful in controlling the itch during severe exacerbations.

Phototherapy (light treatments) or oral immune-modulators (i.e. chemotherapy) under a physician’s supervision can be helpful with severe chronic disease.

Schedule an appointment here at Student Health Services if you’ve having problems with your eczema, or any other skin problem.

As fall and winter approach, critters will be looking for food and warmth, and they may end up in our homes. This might not be so bad, if it was a peaceful coexistence, but mice and rats like to chew holes in your cereal boxes, leave their feces on the floor, and raise their little furry families under your bed.

So maybe you are an animal lover, and willing to clean up after your new companions. The other drawback of these uninvited guests is the range of infectious diseases they can carry:

Hantavirus

Rat-bite fever

Leptospirosis

And others

Hantavirus is an infection you may have heard about this summer, when 9 cases were discovered among campers at Yosemite National Park in California. 3 of those persons died. Exposure occurs from exposure to droppings, urine or saliva. The illness starts with fever and muscle aches, but can develop into a severe pneumonia.

Rabies vaccine may be one of those things you don’t really think about, until you need it. There are two manufacturers of rabies vaccines in the US, and either can be used to prevent rabies, either before (pre-exposure) or after (post-exposure) a bite from an infected animal. Unless you are a veterinarian or have some other type of close contact with animals, you don’t need the pre-exposure vaccines.

Post-exposure vaccine is given whenever a person gets bitten or exposed to a animal potentially infected with rabies. This can sometimes be a tough call, because rabies is not very common in Central Ohio, but there still is some risk. In some cases, post-exposure rabies vaccine is recommended and administered to students here at Student Health Services.

During this vaccine shortage, we will limiting our use of rabies vaccine to post-exposure situations only. That means that some other students will be asked to wait a few weeks or more, but we do this for the good of the whole community, and to try to be sure that we have the vaccine when YOU really need it.

In the meantime:

if you are in a situation where a possible exposure has occured, ask your doctor to consult with local/state public health departments to ensure appropriate use of vaccine.

Q:I was wondering if there is a stomach bug going around in the Central Ohio area? I, along with several others, have been experiencing stomach pain and diarrhea on and off for about a week.

A: As of this posting, there are no unique bugs happening to our knowledge, just the usual episodes of stomach crud. If you are having these symptoms for more than a few days, you should see a clinician for an evaluation.

Student Health watches for any information on clusters of illness in the community that could impact our students. Our colleagues at the OSU Medical Center, Columbus Public Health, and Ohio Department of Health provide expert support.

Meanwhile, with the spring growing season underway, and warmer spring and summer temperatures, it is also the time of year for illnesses related to poor food handling. I hope that was not the case for you, but here are a few tips from the Ohio Department of Health for all of us to keep in mind:

Start clean

Wash hands thoroughly before eating, preparing food, after using the bathroom, changing diapers or after contact with animals.

Thorough hand washing is defined as using warm water and washing with soap for at least 30 seconds. In public restrooms, use a paper towel to turn off the faucet and open the door.

Wash meat thermometers, counters and utensils with hot, soapy water after coming in contact with raw meat.

Wash all fruits and vegetables well, especially those that will be served raw.

Food and Grilling Safety

Keep meat and poultry refrigerated until ready to use, and keep raw meats and their juices away from other foods.

Science has done it again. Dirty pigs are healthier pigs. It has been proven. Don’t ask how, because it involved a lot of fetal pigs (which makes my undergraduate pig dissecting PTSD flare up), poop and blood. But it also involved a lot of wallowing and I am ALL about science that proves that wallowing is good for you.

Sure, the title – Environmentally-acquired bacteria influence microbial diversity and natural innate immune responses at gut surfaces – scintillating as it is, might not immediately strike you as a defense of all that is good about being dirty. But pull up a chair and consider the dirty details.

Gut immunologists took baby pigs and sent them outside, inside or into a kind of antibiotic-laced biologic bubble. The guts of the outdoor, mud-wallowing pigs were full of healthier bacteria than the indoor pig guts. Not only was there more of the good stuff in outdoor beasts, there was also less harmful bacteria in the chute. Most cool and interesting, though, is that the bacterial composition of the piggies’ guts influenced the expression of immunologic genes: pristine, white-glove pork expressed more inflammatory genes and other icky inflammatory stuff.

I know what you’re thinking. Pigs aren’t human, Dr. Rentel. True. Based on this study I’m not going to build a heated pigsty with a giant HDTV for me and my kids in the backyard. There is, however, a growing, stinking, microbial-filled gooey heap of evidence that human interaction with bacteria is good. Why does the prevalence of autoimmune diseases and allergies keep going up? This study gives some very direct, powerful evidence as to how the cascade of autoimmune badness gets started. Okay, yes, in pigs, but pigs are a whole lot like us.

As my favorite infectious disease specialist in the whole wide world (Dr. George Gianakopoulos) used to say, “Nature abhors a vacuum. Kill the good bacteria and welcome in the bad.” I’m not saying you should order dirt for take-out tonight. But skipping the whole-body antimicrobial gel bath every day might not be a bad idea.

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